Retronasal testing of olfactory function: An investigation and comparison in seven countries

Ilona Croy, Heike Hoffmann, Carl Philpott, Philippe Rombaux, Antje Welge-Luessen, Jan Vodicka, Iordanis Konstantinidis, Eduardo Morera, Thomas Hummel

Research output: Contribution to journalArticlepeer-review

43 Citations (Scopus)


Flavor perception is to a large extent determined by olfaction, and persons who lost their sense of smell consequently complain about strongly reduced enjoyment of food. The retronasal olfactory function is especially important for flavor appreciation. The aim of this study was to compare retronasal function across different cultures and to develop a test that is applicable across cultures. Identification of 39 retronasal applied odor probes was tested in a total of 518 participants of seven countries; 292 of them were healthy, and 226 exhibited a smell disorder. A retest was performed with 224 of the healthy participants. Furthermore, all participants were tested for orthonasal threshold, identification, and discrimination ability. Significant cultural differences in identification ability were found in 92 % of the probes. The 20 probes that could be identified above chance in healthy participants of all countries and that could differentiate between patients and controls were selected for the final retronasal test. This test was well able to differentiate between controls and patients in different countries and showed a good coherence with the orthonasal test (r = 0.80) and a good retest-reliability (r = 0.76). Furthermore, it is age-independent. The strong cultural differences observed in retronasal identification underline the necessity to develop a culturally independent instrument. This retronasal test is easy to apply and can be used across different countries for diagnostics and clinical research.
Original languageEnglish
Pages (from-to)1087-1095
Number of pages9
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number5
Early online date3 Sep 2013
Publication statusPublished - May 2014

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